Cholesterol-lowering statins, which are given to tens of millions to prevent heart disease and stroke,s may not have any benefit for the over 75s, a new study suggests.
Statins are a class of medicine that helps lower the body’s cholesterol level. They’re recommended for people thought to be at increased risk of cardiovascular diseases (CVD), such as heart attack or stroke.
Cardiovascular disease is the leading cause of death around the world, especially for people over the age of 75. However, there is actually little evidence of the efficacy of statins when it comes to people taking statins without a diagnosis of heart disease. As such, researchers set out to determine whether statin treatment is actually associated with a reduction in cardiovascular disease and death in people aged over 75.
The new European study, published on Thursday in the prestigious British Medical Journal, used data from 46,864 people, and the results “do not support the widespread use of statins in old and very old populations”.
The team of Spanish researchers analyzed data on almost 47,000 people, with an average age of 77, included in the Catalan primary care system database between 2006 and 2015. The participants were followed up for an average of 5.6 years to see whether they developed cardiovascular disease (CVD) – coronary heart disease, angina, heart attack, and stroke – or if they died.
The authors of the observational study concluded that in participants older than 74 years without type 2 diabetes, statin treatment was not associated with a reduction in CVD or death. As such, the new study is likely to stoke the controversy surrounding the use of the pills.
However, patients with diabetes saw their cardiovascular disease risk reduced by 24 percent and mortality by 16 percent. But even for this group, the protective effect fell after 85 and disappeared by the age of 90.
The researchers, led by Dr. Rafel Ramos, said statin use for the elderly had increased around the world despite a lack of evidence for any benefit, even though the elderly are more prone to side effects.
The report concluded:
‘These results do not support the widespread use of statins in old populations, but do support treatment in those with type 2 diabetes younger than 85.’
Reference:
Rafel Ramos et al. Statins for primary prevention of cardiovascular events and mortality in old and very old adults with and without type 2 diabetes: retrospective cohort study BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3359 (Published 05 September 2018) BMJ 2018;362:k3359